A time for fertility, a time for adoption

AS THE debate continues to rage about the ethics of elderly motherhood and the use of aborted foetus eggs, I found myself being haunted by quite another image. It is of the rows of tiny babies left to wither away in an upstairs 'dying room' in a Chinese orphanage.

This heartbreaking picture was published last month by the Daily Mail: in China, where official policy encourages only one child per couple and sons are deeply desired, baby girls are sometimes abandoned, or worse. A baby, a prize beyond compare for an ageing, infertile Westerner, is also a cheap, disposable life to someone else.

A good number of my friends and acquaintances are facing infertility crises, and I have nothing but the deepest sympathy for their plight. It may well be that egg donation will become, as one of them insists, the 21st century's answer to adoption. But just as global communications mean that a handful of desperate women can flock to whichever centre - at present Rome - that offers them a solution, so it seems only right that there should be a more open debate about adoption across frontiers. Is it so undesirable?

It has always been the case that poorer, overpopulated countries have had surplus orphans and abandoned babies, but it has also been extremely hard for the average person, unless rich or mobile, to adopt from such countries as South America and Romania, and social services can be obstructive. International adoption is also frowned on as politically incorrect - a form of baby imperialism. Our role as richer nations, it is argued, should be to raise standards in these countries so children can stay put. So we aid Romanian orphanages rather than export the babies.

But family friends when I was a child did adopt a Chinese baby, who was abandoned in a doorway in Hong Kong and rescued by missionaries. She grew up in an English suburb, went to university, married and is now a mother. At that time, little conscious effort was made to stress her racial and ethnic inheritance, but as she grew we all used to ask ourselves what on earth would have become of her if she had been left in that doorway.

There are dangers, of course, in an international baby trade: babies could be snatched from their parents and women exploited to breed. Countries also object to being denigrated as unable to provide for their own population. But provided reputable agencies were involved, many individual lives could be blessed by a freer form of international adoption. If, moreover, it becomes acceptable for pre-menopausal women in their forties and even fifties to be aided to have babies, then it also seems quite wrong to close the adoption route to them here at home.

Last November's White Paper, Adoption: the Future, while leaving adoption agencies with the discretion to set rules, seems to encourage ending the assumption that the over-forties are too old. These rules clearly arose because, with perhaps only 2,000 babies a year available, there are simply not enough to go around - especially while the bias against adoption and in favour of keeping a baby with its natural mother remains firmly in place. But perhaps it would be more sensible actually to favour older parents, 35 years and upwards, while concentrating medical fertility treatment on younger people.

And there should be far more attention devoted to preventing infertility. It amazes me that so little checking is carried out by doctors, when we all know that the practice of cervical smear tests is now well established. Many women become infertile through pelvic inflammation and infection, not all of which produce obvious side effects. Many are teenagers when this happens and ignorant of the effect these conditions can have on their later fertility. I was once extremely surprised to find I needed treatment myself, and this was only discovered by chance by a zealous doctor checking out another, unrelated, gynaecological problem. Sex education in schools really ought to add this to the curriculum.

This is why, while so much energy is diverted to these high-prestige, age-of-technology experiments, I find myself concerned that we are addressing only one part of the problem. As Virginia Bottomley ponders where to draw new policy guidelines, she and her officials might start considering the problems of infertility as a whole.